NORTHSHORE HEALTH CENTERS INC NPI 1023440526

NPI Information

NPI: 1023440526
Provider Name: NORTHSHORE HEALTH CENTERS, INC

Doing Business As: NORTHSHORE HAMMOND HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
1828 165TH ST STE A
HAMMOND, IN
ZIP 46320
Phone: (219) 763-8112
Get Directions

NORTHSHORE HEALTH CENTERS, INC is a federally qualified health center (fqhc) clinic center in Hammond, IN. NORTHSHORE HEALTH CENTERS, INC NPI is 1023440526. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Northshore Hammond Health Center.

The provider's business location address is:

1828 165TH ST STE A
HAMMOND, IN
ZIP 46320-823
Phone: (219) 763-8112
Fax: (219) 844-9006

The provider's authorized official is David Hall .
The authorized official title is Ceo and has the following contact phone number (219) 763-8112.

The CLIA number assigned to this NPI record is 15D2175428 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/7/2013 and was last updated on 2/3/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	1041C0700X	Social Worker	Clinical	No
2	111N00000X	Chiropractor		No
3	1223G0001X	Dentist	General Practice	No
4	124Q00000X	Dental Hygienist		No
5	207Q00000X	Family Medicine		No
6	207V00000X	Obstetrics & Gynecology		No
7	208000000X	Pediatrics		No
8	2084P0800X	Psychiatry & Neurology	Psychiatry	No
9	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	No
10	363L00000X	Nurse Practitioner		No
11	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	Yes
12	367A00000X	Advanced Practice Midwife		No
13	363LF0000X	Nurse Practitioner	Family	No
14	363LW0102X	Nurse Practitioner	Women's Health	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	151912	OTHER	INDIANA	MEDICARE PART A PTAN
2	200331170H	MEDICAID	INDIANA
3	191360	OTHER	INDIANA	MEDICARE PART B PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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